One final post for today. A week ago Friday we received word that Jessica is a donor match. When I told her, Jessica said "I get to help Mia again!" with a big smile. Having a donor is a big deal. So we went to SLC to have a consultation with the transplant doctor, Dr. Pulsipher.
Mia's first transplant was an autologous transplant, meaning they used her own stem cells. They are fewer complications with that kind of transplant. She will be having a allogenic transplant this time around. And the complications and side effects are many.
Dr Pulsipher explained why they do these transplant very clearly. Over time the medical world has discovered that the best way to fight cancer is not with chemotherapy drugs but rather it is with immunotherapy. We each have an immune system that is supposed to fight off any foreign or abnormal cell in the body. The immune system should fight off cancer cells however somehow the cancer cells in a patient's body have managed to fool the immune system. So a transplant is in reality an immune system transplant. We are taking the cells from Jessica. Her cells should react with Mia's cells and through a very carefully calculated procedure begin to fight Mia's cells. This is Graph vs Host syndrome. The idea is that while Jessica's cells are fighting Mia's immune system they are also fighting the cancer cells as well. In order for Mia's body to not reject or fight off all of Jessica's cells, Mia will be on immunosuppressant drugs. This allows the new cells to fight more effectively against Mia's cells. Over a course of one to five years Mia will be weaned off the immunosuppressant drugs. Donor, Allogenic, transplants are much harder on a persons body. Given Mia's medical history there is always the possibility of severe side effects. However when the donor is a sibling the side effects are somewhat lessened.
This transplant will require that we be in SLC for a minimum of 107 days. This is what they told us the first time around, but this time they really do mean it. Graph vs host can be very dangerous and doesn't always show up right away. Also the engraphment period takes longer. So she will actually be in the hospital longer than the first time around.
Being able to do the transplant is a good thing, despite the separation from family. Being able to do the transplant means that her body has responded to the latest cancer drug that we tried. It also means that her body is reasonably stable. And she has responded very well to this last drug. Her spleen is back where it should be and can only be felt with very careful examination. Her numbers are better than they have been for three months. Other than not eating and having lost so much weight she is doing really well. A month ago I said that a transplant was not happening anytime soon. In fact I felt that there was a very real possibility that we wouldn't be able to do a transplant at all, that she would never be well enough to have one.
And now here we are. We will will do the transplant just as soon as we can get insurance approval. There is some question as to whether that will be easy or we will have to fight for it. But either way I think we will get approval. And then it is on to SLC.